title: Is modified retroperitoneal lymph node dissection alive for clinical stage I non-seminomatous germ cell testicular tumor?
abstract: OBJECTIVE
  To evaluate efficacy of modified retroperitoneal lymph node dissection (RPLND) in the management of patients with pathological stage (PS) I non-seminomatous germ cell testicular tumor (NSGCT) in a retrospective study.
  
  
  METHODS
  Between April 2002 and April 2012, 55 patients with clinical stage (CS) I NSGCT had undergone modified RPLND according to Sloan-Kettering modified RPLND template. Clinicopathological parameters, retroperitoneal relapse, and antegrade ejaculation rate were evaluated in patients with PS I.
  
  
  RESULTS
  Of 55 patients, 41 (74.5%) and 14 (25.5%) subjects were in PS I and II, respectively. In PS I group, the mean patients' age was 32.8 years (range, 19 to 51 years) at the end of the follow-up period. Three patients missed the follow-up; hence, were excluded from the study. Mean follow-up duration was 56 months (range, 6 to 120 months). Tumor recurrence was identified in no subjects at the end of the follow-up period. Overall peri and postoperative complication rate was 18% (7 patients). Out of 38 patients, 23 (61%) had post RPLND antegrade ejaculation at the end of the study.
  
  
  CONCLUSIONS
  Modified template RPLND is a safe, effective, and sufficient treatment for patients with no retroperitoneal micrometastasis after the procedure. Furthermore, this strategy may obviate the need for close, expensive, and potentially harmful follow-up protocol in patients with PS I NSGCT.
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Ghaed
authors.forename: Nasser
authors.initials: N
authors.lastname: Simforoosh
authors.forename: Ali
authors.initials: A
authors.lastname: Tabibi
authors.forename: Abdolkarim
authors.initials: A
authors.lastname: Danesh
authors.forename: Akbar
authors.initials: A
authors.lastname: Nouralizadeh
authors.forename: Mehdi Kardoust
authors.initials: MK
authors.lastname: Parizi
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult